Key result
Late-onset hyperlactatemia linked to ~1.3 mmol/L higher initial post-bypass lactate in pediatric cardiac surgery.
Why the study?
This study aimed to investigate the effect of operative and postoperative parameters on late-onset hyperlactatemia after cardiac surgery in the pediatric patient population.
Cohort (n=159)
No
Absolute Event Rate: 3.01% vs 1.74%
p-value: p=<0.001
Late-onset hyperlactatemia after pediatric cardiac surgery is associated with higher early post-CPB PaO2 and lactate levels, but does not increase major adverse events or mortality.
Early post-CPB lactate and PaO2 may flag risk for late hyperlactatemia after pediatric VSD repair; leaves open whether oxygenation strategies alter outcomes.
Background: This study aimed to investigate the effect of operative and postoperative parameters on late-onset hyperlactatemia (LOHL) after cardiac surgery in the pediatric patient population. Methods: One hundred fifty-nine ventricular septal defect patients (77 males, 82 females; mean age: 8.0±8.6 years; range, 1 to 48 years) were retrospectively examined between August 2020 and February 2023. Patients with the highest lactate value measured between 6 to 12 h postoperatively <3 mmol/L were defined as Group 1, and those with lactate values ≥3 mmol/L (LOHL) were included in Group 2. Results: Cardiopulmonary bypass (CPB) time, aortic cross-clamp time, and CPB flow did not differ between groups (p=0.916, p=0.729, and p=0.699, respectively). The difference between partial oxygen pressure (PaO 2 ) in the first blood gas obtained after CPB was statistically significant (p=0.017). The lactate level measured in the first arterial blood gas obtained after CPB was 1.74±0.61 mmol/L in Group 1 and 3.01±1.63 mmol/L in Group 2 (p<0.001). The PaO 2 in the arterial blood gas measured at 6 h postoperatively was 129.22±61.20 mmHg in Group 1 and 156.07±64.49 mmHg in Group 2 (p=0.046). Conclusion: The development of hyperlactatemia due to ischemia in the early post-CPB period may affect the development of LOHL. Microcirculatory changes at the tissue level may play a role in the etiology of LOHL.
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Tüzün et al. (2025) conducted a cohort in Ventricular septal defect requiring cardiac surgery (n=159). Late-onset hyperlactatemia (LOHL ≥3 mmol/L at 6-12h) vs. No late-onset hyperlactatemia (<3 mmol/L) was evaluated on Lactate level in the first arterial blood gas after cardiopulmonary bypass (p=<0.001). Pediatric patients who developed late-onset hyperlactatemia had significantly higher initial post-bypass lactate (3.01 vs 1.74 mmol/L, p<0.001) and PaO2 compared to those who did not.
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